This is a randomized, repeated measures, evaluation study to explore the effectiveness of the inpatient Pain and Palliative Care Service intervention. The data collected during this study includes both outcomes of the intervention and patient and family perceptions of the care delivery process including issues surrounding communication with health care providers. Patients with advanced malignancies who are currently participating in NCI Surgery Branch protocols are asked to participate in a pain and symptoms management evaluation study. Each patient and a designated family member is asked to complete a series of questionnaires over time exploring physical, psychosocial and emotional correlates of pain and symptom management. four additional patients have been enrolled in the study during the past year for a total of 152 participants. Subject accrual is complete. Data analysis complete as it applies to the primary endpoints at 3, 6 and 9-months post surgery. Manuscripts completed with more in-depth analysis and triangulation of qualitative and quantitative interview data.